title: Smooth muscle metaplasia and innervation in interstitium of endometriotic lesions related to pain.
abstract: OBJECTIVE
  To investigate the pathogenesis of endometriotic pain.
  
  
  METHODS
  Retrospective nonrandomized immunohistochemical study.
  
  
  METHODS
  A university hospital, Department of Gynecology.
  
  
  METHODS
  Twenty human endometriotic specimens were selected from different lesions including ovarian endometrioma, peritoneal lesion, and deep infiltrating lesion. Premenopausal women with histologically diagnosed endometriosis were selected (mean age 39 years; range, 25-53 years). The chief complaint was dysmenorrhea, dyschezia, and dyspareunia. A rat endometriosis model was induced in 10 SLC-Sprague-Dawley rats (8 weeks old) by surgical autotransplantation of the uterus.
  
  
  METHODS
  Immunohistochemical staining of endometriotic specimens for alpha-smooth muscle actin (ASMA), neural cell adhesion molecule (NCAM), and nerve growth factor (NGF) expression.
  
  
  METHODS
  Comparison of the immunoreactive staining of ASMA, NCAM, and NGF expression in human endometriosis and a rat endometriosis model.
  
  
  RESULTS
  Morphological analysis revealed thick interstitium in both human and rat endometriotic lesions. The major components of fibrotic interstitium are smooth muscle cells, stained by anti-ASMA antibody, and nerve cells, stained by anti-NCAM antibody. Inflammatory cells are also present (e.g., macrophages and lymphocytes) as revealed by anti-NGF antibody staining.
  
  
  CONCLUSIONS
  These results suggest that the contraction of smooth muscle cells and the hyperalgia derived from innervation in the interstitial area is related to pain in endometriosis.
authors.affiliation: Department of Obstetrics and Gynecology, Jichi Medical University Saitama Medical Center, Saitama, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Odagiri
authors.forename: Ryo
authors.initials: R
authors.lastname: Konno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Sachiho
authors.initials: S
authors.lastname: Netsu
authors.forename: Chenghui
authors.initials: C
authors.lastname: Yang
authors.forename: Mitsuaki
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D000199:Actins / Q000378:metabolism; D000328:Adult; D000818:Animals; D004715:Endometriosis / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D008679:Metaplasia / Q000150:complications; D008875:Middle Aged; D009130:Muscle, Smooth / Q000294:innervation* / Q000378:metabolism / Q000473:pathology*; D010049:Ovarian Diseases / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D017699:Pelvic Pain / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D010532:Peritoneal Diseases / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D051381:Rats; D017207:Rats, Sprague-Dawley; D012189:Retrospective Studies; D013799:Theca Cells / Q000473:pathology; D014599:Uterus / Q000294:innervation / Q000473:pathology
chemical_list: D000199:Actins; C541116:ACTA2 protein, human; C498862:Acta2 protein, rat